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PubMed1992

Advantages of peripheral radiogrametry over dual-photon absorptiometry of the spine in the assessment of prevalence of osteoporotic vertebral fractures in women.

Since osteoporosis develops in most postmenopausal women and is probably the most important single factor in the pathogenesis of osteoporotic fractures of the spine, hip, and wrist (and at other sites), methods suitable for mass screening should be developed. In this study of 97 women aged 24-79, measurements of the lumbar spine mineral content by dual-photon absorptiometry (DPA) were compared with the summed combined cortical thickness measurements from radiographs of the radius and metacarpal II (MR). There was good correlation between the two methods (r = 0.90). The correlation of age with MR was higher than with DPA. The correlation of years postmenopause was significant with MR but not with DPA. Taking the -2 SD level of the premenopausal means to be previously established vertebral fracture thresholds, 24% of the DPA measurements, but no MR measurements in patients with vertebral compressions, were above the fracture threshold. Since MR measurement requires taking only two small plain radiographs using ordinary x-ray equipment, it is concluded that this less expensive method is better suited to screening for osteoporotic vertebral fracture risk in postmenopausal women than DPA.

Absorptiometry, Photon↗
PubMed2004

An interactive psychoeducational intervention for women at risk of developing an eating disorder.

This study evaluated a synchronous Internet-delivered intervention (chat room) for improving eating habits and body image in college-age women at risk for developing an eating disorder. Sixty at-risk women (mean age = 18.9, SD = 2.4; 65.0% Caucasian, 19% Latino/Hispanic, 8% Asian/Pacific Islander, 3% African American, 5% other; mean body mass index = 25.6, SD = 5.7) were randomly assigned to intervention (n = 30) or control (n = 30) groups. Once a week for 8 weeks, participants used a private chat room for a 1-hr moderated discussion focused on improving body image and eating behaviors. Additional treatment components included psychoeducation, asynchronous support, homework, and summaries. Assessments were conducted at baseline, posttreatment, and 10 weeks after posttreatment. Participants indicated high satisfaction with the intervention mode. Intervention participants significantly reduced eating pathology and improved self-esteem over controls at follow-up. These findings suggest that synchronous, Internet-delivered programs are efficacious and have potential to reduce problematic attitudes and behaviors that may lead to eating disorders among college-age women.

Adolescent↗
PubMed2004

Women and anxiety disorders: implications for diagnosis and treatment. Proceedings of a conference, November 19-21, 2003, Chantilly, Virginia, USA.

Community studies indicate that 19% of men and 31% of women will develop some type of anxiety disorder during their lifetime. The impact of gender is profound in that it increases the likelihood of developing an anxiety disorder by 85% in women compared to men. Sex difference in prevalence rates are apparent as early as age 6, when girls are twice as likely as boys to have an anxiety disorder. In the National Comorbidity Survey, the prevalence rates for panic disorder in women and men were 5% and 2%, respectively. Agoraphobia, which often coexists with panic disorder, has a lifetime prevalence rate of 7% in women and 3.5% in men. Prevalence of trauma is increased in young women as well, and is experienced earlier in life; 62% of sexual assaults are inflicted on females < or = 18 years of age, and 29% occur in children < 11 years of age. Comorbidity of anxiety in women complicates other medical conditions as well. For example, panic disorder is highly comorbid with CHD, which remains the leading cause of death in women in developed countries. Fluctuations in reproductive hormone levels during the female life cycle is thought to be responsible for modulating anxiety. This is often implicated in the later age of onset, the more sudden and acute symptom emergence, and the more episodic course of OCD in women, and in the high prevalence(47.4%) of PMDD. Pregnancy appears to be a protective period for some anxiety disorders, including panic, while for others, such as OCD, it may be associated with onset. Hormonal changes during pregnancy, such as increased prolactin, oxytocin, and cortisol, may contribute to the suppression of stress response that occurs during this period. Despite a large and growing body of literature on anxiety disorders in general, the available data relating to women and girls falls short of informing aspects of diagnosis, treatment, and prevention that may entail sex differences. Additional work is required to understand the biological and psychosocial causes of these differences.

Anxiety Disorders↗
PubMed1993

[Intervention in mental health: an unexpected function of shelters for homeless women].

The development of services for the homeless is today the target of widespread criticism. Institutions are tending to duplicate services to ensure their survival, which brings about the risk of creating second-rate services for this area of the population. In addition, many critics fear that, because of policies established by institutions, services for the homeless tend to foster rather than fight transience. Based on an analysis of the evolution of mandates of shelters for homeless women, the author suggests that the development of services for the homeless has been influenced by factors other than the survival instinct of these organizations.

Attitude of Health Personnel↗
PubMedDate not supplied

Contraceptive use during lactation in developing countries.

Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding women's use of the pill and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women.

Breast Feeding↗
PubMed1994

Postmenopausal frontal fibrosing alopecia. Scarring alopecia in a pattern distribution.

BACKGROUND: Recession of the frontal hairline is a common event in postmenopausal women. This has been shown not to be a marker of gross androgenization, and is usually a progressive nonscarring alopecia. Six postmenopausal women, who developed a progressive frontal scarring alopecia, were studied and their clinical and laboratory data, as well as the results of scalp biopsy specimens in all six patients, were analyzed and compared with recognized forms of scarring alopecia and recently described findings in androgenetic alopecia. OBSERVATIONS: The six postmenopausal women developed a progressive frontal hairline recession that was associated with perifollicular erythema within the marginal hairline, producing a frontal fibrosing alopecia extending to the temporal and parietal hair margins. Scalp biopsy specimens from the frontal hair margin showed perifollicular fibrosis and lymphocytic inflammation concentrated around the isthmus and infundibular areas of the follicles. Immunophenotyping of the lymphocytes showed a dominance of activated T-helper cells. Clinical review of all six cases showed a progressive marginal alopecia without the typical multifocal areas of involvement seen in lichen planopilaris or pseudopelade. None of the patients had mucous membrane or skin lesions typical of lichen planus. Hormonal studies, in five patients, showed no elevated androgen abnormalities. CONCLUSIONS: Progressive frontal recession in postmenopausal women may show clinical features of a fibrosing alopecia. The histologic findings are indistinguishable from those seen in lichen planopilaris. However, the absence of associated lesions of lichen planus in all six women raises the possibility that this mode of follicular destruction represents a reaction pattern triggered by the events underlying postmenopausal frontal hairline recession.

Aged↗
PubMed2003

Serum insulin-like growth factors in normal pregnancy and in pregnancies complicated by preeclampsia.

BACKGROUND: Lower levels of insulin-like growth factor I (IGF-I) have been shown to be associated with preeclampsia and also with a reduced risk of breast cancer later in life. Lower levels of IGF before clinical signs of preeclampsia could be one possible mechanism in the etiology of preeclampsia as well as for the reduced risk of breast cancer associated with preeclampsia. We have prospectively investigated maternal serum levels of IGF-I, IGF-II, and the main binding protein insulin-like growth factor binding protein 3 (IGFBP-3) in women with and without preeclampsia. METHODS: We used maternal serum samples from a Swedish-Norwegian cohort study obtained in the 17th and 33rd gestational week from 30 women who subsequently developed preeclampsia and 128 women who did not develop preeclampsia. RESULTS: There were no significant differences in serum concentrations IGF-I and IGFBP-3 in the 17th or the 33rd week of gestation between women who developed preeclampsia or not. Compared with nonpreeclamptic women, preeclamptic women had significantly higher serum levels of IGF-II in week 33, but there was no difference in week 17. CONCLUSION: In women who developed preeclampsia, we found no support for the hypothesis that the disease was preceded by lower serum levels of IGF-I and IGF-II, or higher serum levels of IGFBP-3. However, among women who later developed preeclampsia, serum levels of IGF-II were significantly higher in the 33rd gestational week.

Adult↗
PubMed2006

Late entry to antenatal care in New South Wales, Australia.

AIMS: This study aimed to assess the prevalence of women who entered antenatal care (ANC) late and to identify factors related to the late entry to ANC in New South Wales (NSW) in 2004. METHODS: The NSW Midwives Data Collection contained data of 85,034 women who gave birth in 2004. Data were downloaded using SAS and transferred to STATA 8.0. Entering ANC after 12 weeks of gestation was classified as late. The Andersen Health Seeking Behaviour Model was used for selection and analyses of related factors. Regression and hierarchical analyses were used to identify significant factors and their relative contributions to the variation of pregnancy duration at entry to ANC. RESULTS: 41% of women commenced ANC after 12 weeks of gestation. Inequality existed between groups of women with predisposing characteristics and enabling resources contributed more to the variation in pregnancy duration at entry to ANC than needs. The groups of women with highest risk were teenagers, migrants from developing countries, women living in Western Sydney, Aboriginal and Torres Strait Islanders, women with three or more previous pregnancies and heavy smokers. The high risk groups with largest number of women were migrants from developing countries and women living in Western Sydney. CONCLUSION: A large number of women in NSW entered ANC late in their pregnancies. Efforts to increase early entry to ANC should be targeted on identified high risk groups of women.

Journal Article↗
PubMed1988

Intermittent weekly contraction monitoring to predict preterm labor in low-risk women: a blinded study.

To assess the predictive value of uterine activity as a marker for subsequent preterm labor, 139 black, inner city women were monitored at least three times for 1 hour between 28-32 weeks' gestation using a portable tocodynamometer. All had singleton gestations and gave no previous history of preterm labor or delivery. They were monitored between 8 and 10 AM while sitting in the clinic waiting area. Uterine activity records, numbered randomly, were transmitted by telephone to a site remote from the hospital. No one having any clinical contact with the participants saw or received feedback regarding the contraction data. Tocodynamometry records were then mailed to another center where they were read by one investigator blinded to all clinical information. The mean contraction frequency during the single hour of weekly testing was significantly greater for the 16 women who developed preterm labor than for women who delivered at term at each point between weeks 28-32. Using greater than six contractions per hour on at least one occasion between 28-32 weeks' gestation as a predictor would have identified 12 of 16 women (sensitivity 75%) who subsequently developed preterm labor. This contraction frequency was noted in 26 of 123 women (21%) who labored at term (specificity 79%; P = .0003).

Female↗
PubMed1980

Measurement of euglobulin fibrinolysis time in women with retarded fetal development. The effect of the clamping and step tests on plasminogen activator activity.

The effects of two experimental stimuli, clamping of the cubital vein and exercise (step test), on the euglobulin lysis time of women with retarded fetal development (92 cases), with physiologic pregnancy (50 cases) and non-pregnant women (20 cases) were studied. Both tests resulted in a pronounced shortening of euglobulin lysis time in the non-pregnant and to a lesser extent in the physiologic pregnancy cases (statistically significant after clamping of the cubital vein, statistically insignificant after the step test). In the etiologically heterogeneous group of pregnancy with retarded fetal development the response to both stimuli was weaker in comparison with the normal pregnancy group, and in many cases (58.7%) even "paradoxical", that is, instead of a rise in fibrinolytic activity, a fall was observed. These results indicate that in women with retarded fetal development fibrinolytic activity of the blood doses not rise as readily as it does in normal pregnancies. This applies both to local response (clamping test) and systemic response (step test), and is probably due to a fall in the plasminogen activator content of the venous vessel walls. As a working hypothesis, it is presumed that insufficiency of the plasminogen activator activity system facilitates the accumulation of fibrin deposits in the uterine--placental blood circulation, and contributes to retardation of intrauterine fetal growth.

Exercise Test↗
PubMed1996

Assessing women's potential risk of developing breast cancer.

Available data show that women tend to overestimate their risk of developing breast cancer. Available models allow for the rapid identification of women who are at increased risk for breast cancer, along with a quantitative estimate of their probability of developing breast cancer over a period of years or by a certain age. Important risk factors include age; family history of breast cancer in first-degree (mother, sister, or daughter) or second-degree (aunt or grandmother) relatives; history of biopsy for benign breast disease, with or without atypical hyperplasia; nulliparity or first live birth after age 30; and menarche before age 12. Risk should be quantified routinely when women seek advice about breast cancer risk-management strategies. Counseling, with appropriate referrals when required, should always accompany specific recommendations for managing risk. Additional predictive models are needed for nonwhite women and for women not being screened regularly with mammography.

Biopsy↗
PubMed2005

[Risks factors for the development of diabetes in women with history of gestational diabetes mellitus].

UNLABELLED: Women who suffered from impaired carbohydrate metabolism during pregnancy are more likely to develop different types of diabetes later in their lives. The aim of this paper was to study the risk factors for the development of diabetes in group of women with gestational diabetes mellitus (GDM) in anamnesis. MATERIALS AND METHODS: 200 women took part in this study, who had gestational diabetes diagnosed between 1980-1998. All women were divided into 4 groups depending on the type of disorders occurring at the moment of examination: DM1 - women diagnosed with type I diabetes, DM2 - women diagnosed with type 2 diabetes, IGT-women with glucose levels in OGTT, which applied to impaired glucose tolerance (acc. to WHO criteria), NDM - women with no clinical signs of diabetes, with normal result of OGTT. RESULTS: The risk of diabetes development is significantly higher (independently of the clinical type) in women who had had GDM include: high glucose levels at the time of GDM diagnosis, early onset of symptoms - related to weeks of gestation, and the insulin treatment during pregnancy. However multifactor analysis indicates that the only significant risk factors for DM 1 are early onset of diabetes during pregnancy and high glucose levels 2 hours after OGTT during pregnancy (p < 0.05). High levels of glucose 2 hours after OGTT and high Body Mass Index (BMI) turned out to be the independent risk factors of diabetes type 2 (p < 0.05). CONCLUSIONS: Knowledge of risk factors allows to recognize a diabetes high risk group among women who suffered from diabetes during pregnancy.

Adult↗
PubMed1992

The influence of sphincter control and genital sensation on body image and gender identity in women.

The development of one aspect of feeling female is hypothesized to account for certain phenomena in the treatment of young women patients. Fear of loss of genital pleasure experienced as contractions of the anal and genital-urinary sphincters is seen as the central issue in conflicts manifested in genital, oral, and anal modalities. It is suggested that the female's awareness of her genital arises from the generalization of sphincter sensation in the little girl, which is then represented in the body image. The body image is postulated as a link between genital pleasure and the valuing of femininity.

Adult↗
PubMed1989

A clinical model for diagnosis of urinary tract infection in young women.

To develop a clinical model for diagnosis of bacterial urinary tract infection, we conducted a prospective study on 266 dysuric young women, 147 of whom had urinary tract infections. Five variables were found to be significant and independent correlates to bacterial urinary tract infection on logistic regression analysis: sexual activity, absence of vaginal discharge, short duration of complaints, leukocyturia, and hematuria. An algorithm combining the logistic model and a Gram-stained urine specimen, which was used in only a third of our patients, afforded a sensitivity of 86% and a specificity of 84%. The algorithm was validated in a second set of 166 dysuric women, 77 of whom had urinary tract infections. The algorithm led to a diagnosis of bacterial urinary tract infection with a sensitivity of 91% and specificity of 79%; the only laboratory test needed except for urinalysis was a Gram's stain of urine, obtained for 30% of the patients.

Adolescent↗
PubMed1996

Anxiety in women "at risk' of developing breast cancer.

Do family history clinics offering counselling, surveillance and preventative programmes alleviate or exacerbate anxiety in women at a high risk of developing breast cancer? In this study risk perceptions and anxiety of 99 'at risk' women participating in the Tamoxifen Prevention Trial were compared with those of 87 'at risk' women not attending any specialist clinic who were recruited from the National Breast Screening Programme (NBSP). Most anxiety was found in NBSP women with a family history. Women attending the family history clinic and participating in the trial had anxiety scores comparable with 86 women recruited from the NBSP who did not have a family history. We conclude that such specialist clinics do not see a selected group of the most anxious 'at risk' women nor does participation in tamoxifen prevention programmes appear to increase anxiety.

Analysis of Variance↗
PubMed1993

Diabetes in pregnancy in Zuni Indian women. Prevalence and subsequent development of clinical diabetes after gestational diabetes.

OBJECTIVE: To determine the prevalence of gestational diabetes mellitus in Zuni Indian women and the subsequent rate of diabetes among Zuni women with GDM. RESEARCH DESIGN AND METHODS: A retrospective analysis of 809 deliveries over a 4-yr period among Zuni Indian women was conducted to determine the prevalence of GDM and diabetes antedating pregnancy. A prospective case-control study of 47 full-blooded Zuni Indian women with GDM and 47 control subjects was performed to determine the progression to clinical diabetes in women with a first-time diagnosis of GDM. Cases with GDM delivered during a defined 8-yr period. The control group of Zuni women delivered during the same time period but had plasma glucose values < 7.8 mM on the 1-h glucose screening test. Cases with GDM and control subjects were matched for age, body mass index, gravidity, and length of follow-up. All women were re-evaluated for diabetes up to 9 yr after the index pregnancy. RESULTS: Between 1987-1990, 116 cases of GDM and 8 cases of pre-existing diabetes were identified, giving a prevalence of maternal diabetes in pregnancy of 15.3%. At the time of follow-up, 14 of 47 (30%) women with GDM had developed diabetes after a mean of 4.8 yr compared with only 3 of 47 (6%) from the control group with an average of 5.5 yr follow-up. CONCLUSIONS: GDM is prevalent among Zuni Indians and is associated with an increased risk of diabetes. Glucose tolerance after GDM may deteriorate at a greater rate in Native Americans than in other populations.

Adult↗
PubMedDate not supplied

Depression in women.

In both developing and developed regions, depression is women's leading cause of disease burden. The burden of mental illnesses, including depression, has been seriously underestimated by traditional approaches that measure mortality and not disability. While psychiatric conditions are responsible for little more than 1% of deaths, they account for almost 11% of disease burden worldwide.

Cost of Illness↗
PubMed2002

Dietary patterns predict the development of overweight in women: The Framingham Nutrition Studies.

OBJECTIVE: To investigate relationships between dietary patterns and the development of overweight. DESIGN: Longitudinal analyses during 12 years of follow-up involved the identification of dietary patterns at baseline using cluster analysis applied to a 145-item semiquantitative food frequency questionnaire. SUBJECTS/SETTING: 737 non-overweight women in the Framingham Offspring/Spouse cohort (mean age, 45 years). MAIN OUTCOME MEASURE: Development of overweight (BMI> or =25) at follow-up. STATISTICAL ANALYSES: Relative risks were calculated using Proc Genmod and multivariate models comprehensively considered potential confounders. RESULTS: Five dietary patterns were identified among the cohort at baseline: Heart Healthy, Light Eating, Wine and Moderate Eating, High Fat, and Empty Calorie. Over 12 years, the crude risk of becoming overweight was 29% overall, ranging from 22% of women in the Wine and Moderate Eating cluster to 41% of women in the Empty Calorie cluster. Compared with women who ate a lower-fat, nutritionally varied Heart Healthy diet, women who ate an Empty Calorie diet that was rich in sweets and fats with fewer servings of nutrient-dense fruits, vegetables, and lean food choices were at higher risk for developing overweight [RR 1.4, 95% CI (0.9, 2.2)] after adjusting for age, smoking status, physical activity, menopausal status, energy intake, intentional dieting, and usual weight pattern. Women who ate an Empty Calorie dietary pattern were also younger and were more likely to smoke. CONCLUSIONS: Behavioral interventions for weight management and obesity prevention may be enhanced by creatively targeting differences in eating patterns, dietary quality, and other lifestyle behaviors of distinct subgroups of the population.

Adult↗